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Concerns About Anesthetizing Palatal Tissues
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References 1. Emanuel EJ, Wendler D, Grady C: What makes clinical research ethical? JAMA 283:2701, 2000 2. American Medical Association (AMA): Informed consent updated. 1998; update 2005. Available at: http://www.ama-assn.org/ ama/pub/category/4608.html. Accessed January 28, 2006 3. Jefford M, Moore R: Improvement of informed consent and the quality of consent documents. Lancet Oncol 9:485, 2008
LETTERS TO THE EDITOR involved raising the mucoperiosteal flap than the extraction itself. In our other study,3 in all groups analyzed, a few patients complained of pain during suturing when the needle perforated the palatal mucosa. This pain, however, was considered mild and no patient accepted a supplemental palatal injection, more commonly stating that the injection would probably be more painful than the slight discomfort produced by suturing. Therefore, we believe the authors’ conclusion is not comprehensive when the technique is applied in clinical practice.
doi:10.1016/j.joms.2010.10.028
SONG FAN, DDS WEI-LIANG CHEN, DDS, MS, MBA Guangzhou, China
CONCERNS ABOUT ANESTHETIZING PALATAL TISSUES To the Editor:—We wish to raise a few concerns regarding the article, “Is it possible to anesthetize palatal tissues with buccal 4% articaine injection?” published in May 2010.1 The study authors did not use the upper third molar in any 1 experiment, and they did not perform a posterior alveolar superior nerve block, only a single terminal infiltrative anesthesia supraperiosteal block. We believe that the conclusion, namely an absence of local anesthesia diffusion on magnetic resonance imaging and needle-prick stimulation assessment related to the efficacy of a buccal injection, is not full scale. In our study,2 we used the needle prick on the palatal mucosa in some patients who reported pain. However, the extraction could be performed successfully, and sometimes the most pain occurred when palatal gingivae were separated before removal. We believe that sensation around the palatal pericementum is not identical to that of the palatal mucosa. In fact, the pericementum is mainly involved when extraction is performed, and we noticed that a patient would feel more pain when the extraction
JOSÉ LACET DE LIMA-JÚNIOR, DDS, MS EDUARDO DIAS-RIBEIRO, DDS, MS Bauru, Brazil
References 1. Özeç I, Tas¸demir U, Gümüs¸ C, Solak O: Is it possible to anesthetize palatal tissues with buccal 4% articaine injection? J Oral Maxillofac Surg 68:1032, 2010 2. Fan S, Chen WL, Yang ZH, et al: Comparison of the efficiencies of permanent maxillary tooth removal performed with single buccal infiltration versus routine buccal and palatal injection. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 107:359, 2009 3. Lima-Júnior JL, Dias-Ribeiro E, de Araújo TN, et al: Evaluation of the buccal vestibule-palatal diffusion of 4% articaine hydrochloride in impacted maxillary third molar extractions. Med Oral Patol Oral Cir Bucal 14:E129, 2009
doi:10.1016/j.joms.2010.10.029
References 1. Emanuel EJ, Wendler D, Grady C: What makes clinical research ethical? JAMA 283:2701, 2000 2. American Medical Association (AMA): Informed consent updated. 1998; update 2005. Available at: http://www.ama-assn.org/ ama/pub/category/4608.html. Accessed January 28, 2006 3. Jefford M, Moore R: Improvement of informed consent and the quality of consent documents. Lancet Oncol 9:485, 2008
LETTERS TO THE EDITOR involved raising the mucoperiosteal flap than the extraction itself. In our other study,3 in all groups analyzed, a few patients complained of pain during suturing when the needle perforated the palatal mucosa. This pain, however, was considered mild and no patient accepted a supplemental palatal injection, more commonly stating that the injection would probably be more painful than the slight discomfort produced by suturing. Therefore, we believe the authors’ conclusion is not comprehensive when the technique is applied in clinical practice.
doi:10.1016/j.joms.2010.10.028
SONG FAN, DDS WEI-LIANG CHEN, DDS, MS, MBA Guangzhou, China
CONCERNS ABOUT ANESTHETIZING PALATAL TISSUES To the Editor:—We wish to raise a few concerns regarding the article, “Is it possible to anesthetize palatal tissues with buccal 4% articaine injection?” published in May 2010.1 The study authors did not use the upper third molar in any 1 experiment, and they did not perform a posterior alveolar superior nerve block, only a single terminal infiltrative anesthesia supraperiosteal block. We believe that the conclusion, namely an absence of local anesthesia diffusion on magnetic resonance imaging and needle-prick stimulation assessment related to the efficacy of a buccal injection, is not full scale. In our study,2 we used the needle prick on the palatal mucosa in some patients who reported pain. However, the extraction could be performed successfully, and sometimes the most pain occurred when palatal gingivae were separated before removal. We believe that sensation around the palatal pericementum is not identical to that of the palatal mucosa. In fact, the pericementum is mainly involved when extraction is performed, and we noticed that a patient would feel more pain when the extraction
JOSÉ LACET DE LIMA-JÚNIOR, DDS, MS EDUARDO DIAS-RIBEIRO, DDS, MS Bauru, Brazil
References 1. Özeç I, Tas¸demir U, Gümüs¸ C, Solak O: Is it possible to anesthetize palatal tissues with buccal 4% articaine injection? J Oral Maxillofac Surg 68:1032, 2010 2. Fan S, Chen WL, Yang ZH, et al: Comparison of the efficiencies of permanent maxillary tooth removal performed with single buccal infiltration versus routine buccal and palatal injection. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 107:359, 2009 3. Lima-Júnior JL, Dias-Ribeiro E, de Araújo TN, et al: Evaluation of the buccal vestibule-palatal diffusion of 4% articaine hydrochloride in impacted maxillary third molar extractions. Med Oral Patol Oral Cir Bucal 14:E129, 2009
doi:10.1016/j.joms.2010.10.029